‘League of Denial’ documentary spurs concussion debate

PBS aired a fascinating episode of its Frontline show last week, titled “League of Denial: The NFL’s Concussion Crisis.”

The program was a thorough investigation examining whether the NFL has covered up the risks of long-term football on the brain.

This comes in the aftermath of a $765 million settlement by the NFL with more than 4,500 former players who were suing the league for allegedly concealing a link between traumatic brain injuries and professional football.

In August, it was announced that ESPN had withdrawn from a partnership on the documentary after a 15-month collaboration. I would guess this is because, at least in part, NFL football is a big part of the network’s revenue stream.

One of the most chilling stories told in the piece was by longtime sports agent Leigh Steinberg. He became frightened by Troy Aikman’s concussion from taking a knee to the head in the 1994 NFC championship game. He was with him in a darkened hospital room that night.

He looked at me and he said, “Leigh, where am I?” And I said, “Well, you’re in the hospital.” And he said, ‘Well, why am I here?’ And I said, “because you suffered a concussion today.” And he said, “Well, who did we play?” And I said, “The 49ers.” And he said, “Did we win?” “Yes, you won.” “Did I play well?” “Yes, you played well.” “And so what’s that mean?” “It means you’re going to the Super Bowl.”

Five minutes later, Aikman turned to Steinberg and asked again, “What am I doing here?” So, they repeated the same conversation over again.

Then, maybe 10 minutes passed, and Aikman looked at his agent with the same puzzled look, and again asked where he was, and what was he doing there?

CTE evidence

Much of the show was more scientific in nature, disclosing evidence in many deceased NFL players’ brains of chronic traumatic encephalopathy, or CTE. The first hard evidence was found in the brain of legendary Steelers center Mike Webster, who died at age 50.

As a neuropathologist, Nigerian doctor Bennett Omalu knew little about football, but he knew what he saw in the autopsy of Webster that things were far worse than your normal 50-year-old brain. He was discouraged from going further with his findings, allegedly, by a league doctor who told him of the implications for football if America became overly alarmed.

CTE was eventually found to be widespread in the brains of many NFL players, including Junior Seau. He was certainly not the only troubled ex-player who took his own life after physical and mental difficulties.

In 2009, a leaked NFL research study spurred wide-ranging debate. Former players, the research found, suffered from memory-related diseases at a rate that was 19 times higher than the general population.

The documentary showed how the league tried to back away from the findings, and attempted to discredit them. All the while, more former players were showing symptoms of CTE, such as mood changes, aggression, memory loss, cognition issues, or impulsivity. Wives of ex-players on the documentary said they no longer lived with the man they married.

Try holding a cup of water while driving, and slam on the brakes, even at 5 mph. That’s the jarring action on the brain inside the skull in a high-impact collision. Even with protection, such as the Guardian caps on helmets worn by the Creston/O-M team, the repetition on NCAA and NFL players over time is concerning.

Soccer, ice hockey, rugby (no helmet at all), boxing and mixed martial arts are some of the other obvious sports where blows to the head or body could be concussive, repeatedly.

Local care

The comforting thing in my work is the observation that this subject is being taken more seriously than in the past, and kids aren’t put right back in the game after getting their “bell rung” like in the old days.

Part of this is due to the presence of certified athletic trainers, such as Chris Leonard in Creston, at games and practices. This profession is at the forefront of the education, prevention, treatment and follow-up care of concussions.

And, the Iowa high school boys and girls athletic associations have mandates now, requiring approval of certified medical personnel before an athlete participates after being diagnosed with concussion symptoms.

You’re never going to prevent concussions in organized football at any level, but I’m pleased to see a new brand of awareness and caution. NFL teams now have padded practice once a week when the season gets going. The new Pac 12 policy limits teams to two full-contact practices per week during the regular season and spring drills. (This is different than the “thud” sessions involving “wrapping up” instead of full contact to the ground.)

Creston/O-M high school players have practiced without full contact for two weeks, as it’s healing time for a bunch of dinged-up kids late in a rugged season.

And now, some of the training and expertise in handling head injuries has filtered down to the youth football level, at an age when the brain is most susceptible to jarring injury inside the skull, according to the Frontline documentary. Even though the collisions are less violent, those youngsters’ brains are said to be the least able to handle a damaging blow.

A Virginia Tech study tracked 50 youth football players, ages 9 to 12, with helmet devices and suggested cutting down the number of high-impact drills in practice. If you cut contact drills to no more than a third of the practice time, that takes the average of head impacts per player from 300 a season down to about 150. Pop Warner rules also prohibit contact during special teams drills.

You hear all kinds of opinions about when to allow the start of tackle football. New Orleans Saints quarterback Drew Brees said recently that his three sons ages 4, 2 and 1 will be allowed to play when they are “teenagers.” I assume he means junior high.

Others are supportive of the tackle leagues for fourth through sixth grades, which are rapidly replacing the former flag football programs for that age group.

John Shiltz of Creston was involved in getting the Pride of Iowa Youth Football League organized, a league which has grown to 23 teams throughout southwest Iowa and northern Missouri. He said extra precautions are taken.

Every coach who helps is supposed to be certified with USA Football, and the USA Football site has a variety of drills and videos to help coach kids the proper techniques.

Shiltz said coaches are trained in the “Heads Up” tackling course, sponsored by the NFL. Concussion protocol is covered in the training, so they can recognize potential problems and immediately get that kid out of harm’s way. Sometimes it’s teammates that first notice a kid isn’t acting right, or showing confusion.

“It’s pretty cool that people everywhere are getting on board about how serious this really is,” Shiltz said. “We are taking every precaution.”

I love football, and enjoyed watching my sons play. But I now find myself watching football on TV differently. When I see those big “highlight” hits, I now realize it might be another notch on the road to a troubling future for that person.

There is so much money to be made in the NFL, it’s not going anywhere. But, like advances in tobacco research and the cultural changes that evolved, what will society’s attitude be about brain damage and football in 20 years? More debate about additional rule changes?